Emergency Ward 10

san juan de dios


My husband returned from hospital today.

He was taken ill on Sunday last….he has a foul nasty now -after years of diagnosis, misdiagnosis  and stabs in the dark – known as CANOMAD and has had attacks from time to time over the last thirty years.

While it might sound like a variant of rabies the easiest way to describe it is that if he catches a ‘flu’ bug, instead of his antibodies attacking the bug his antibodies attack him, destroying the nerve sheaths and rendering him paralysed.

It starts in his lips, progresses via his tongue and throat and if not treated in time would paralyse his lungs….so we have to live near a hospital that can treat him with immunoglobulin – the only treatment known to medical science – which costs an arm and a leg.

Thus at three thirty on Sunday morning we were belting along in a CAJA (Costa Rican national health service) ambulance which swooped down the switchback curves of the road to the capital at a speed far in excess of that proposed for the conditions  – which was fine until we hit- in every sense – the intermediate town.

With a view to winning the elections the outgoing mayor had installed speed bumps on the main road through  the town centre.

‘Bump’ is not an adequate description…think Big Dipper.

Our driver had not passed that way since the bumps were installed so we hit them at a speed which achieved a fair semblance of lift off, Leo flying into the air from his stretcher and descending with an audible thump while I picked myself off the floor and extended my vocabulary by listening to the driver’s commentary.

I wish I had written it down….certain phrases had an almost biblical intensity, with use of the ‘selah’  at key intervals.

Unloaded at the Emergency department, into a scene which Cecil B de Mille would envy…patients, family of same en masse, Red Cross staff trying to reclaim their wheelchairs and stretchers, cleaners wielding mops, catering staff in hairnets distributing coffee while nurses, doctors and medical students produced organisation from chaos.

Luckily my husband is an inpatient at the hospital, so his dossier was available, diagnosis made and treatment ordered – as soon as there was a bed available in the Emergency department – no good looking further as the hospital was full to bursting point.

Bed finding was the speciality of a senior female doctor who bore a great resemblance to Granny Giles – without the hat.

grandma giles

She stalked the wards and corridors in search of prey…and pounced.

A gentleman in his sixties, safely esconced in a bed, was complaining loudly that no one would bring him a coffee.

Granny Giles studied his file and summoned a porter.

Get this gentleman back in his own clothes, give him a coffee and send him home by ambulance. If his lungs are strong enough to bellow like that he can bellow at home….

So Leo’s treatment commenced…

On Monday he was transferred to another ward….and I discovered the visiting system….

First, you have to obtain a visiting card. This card resembles a zoo entrance ticket in that it firmly forbids feeding the inmates.

Then you have to turn up at visiting hours: for anyone who remembers the NHS of the fifties and sixties this springs no surprises.

But this hospital has its own way of running things. There is a check point where staff make sure that no illicit pork scrachings, booze or sticky sweets are being smuggled in – and the queue runs outside the hospital and round two blocks.

Unless you are a pensioner. In which case you wait on specially reserved seats and are let through first to many cracks about age before beauty and give the young ladies priority to have the  time to titivate themselves…

Thank goodness for Danilo who held the fort while I took the bus to the capital…a three hour round trip apart from the visiting. Alone, trying to close up the sheep in the dark, I would have been pushed to the limits.

Still, daily life went  on regardless so late in the week I ‘phoned my mother to get her shopping list which would go online to Tesco and in due course be delivered to her door.

After close consideration of the merits of gammon as opposed to a beef joint business was concluded and mother got down to the events of the week.

Mother in Southampton, when on form, can give Disgusted of Tunbridge Wells a fair  run for its money and she was loaded for bear.

Sport mad, she cannot watch cricket as she will not pay for Sky but she was up to date with the news.

What’s all this about the West Indian Under 19 team running about naked?

Mind boggling gently I seek further particulars.

Well, they’re not wearing anything and the umpires are letting them!

How do you know…you can’t watch the match on the box.

They’re talking about it on Test Match Special….they’re running out men wearing no clothes.

Who is doing the running out?

Someone naked. His name begins with M but I can’t remember it…

A  cup of tea later I attempt to unravel the mystery.

It appears that the West Indies Under 19 team’s bowler ran out an opposing batsman in a way which was within the Laws of cricket but which was deemed unsporting.

The thing is called a Mankad– after the first chap to try it in the modern era.

What mother is thinking of is a Mankini…..


I agree that players wearing mankinis might well encourage audiences…but what I would like to know is how mother discovered the mankini…



51 thoughts on “Emergency Ward 10”

  1. I was going to leave a sober and solicitous comment with effusive wishes for Leo’s health…bugger! You posted that photo.I mean, he’s not such a bad-looking chap,well, at least not obese.But the lime fluorescent! One cannot un-see that.

  2. I’m glad your husband has recovered from this latest bout. I was surprised after you said you need to live near a hospital, that it takes an hour and a half to get there. It’s terrible that his treatment costs so much as well.
    I was further surprised when you explained so matter of factly how you deal with your Mum’s Tesco delivery in the UK from where you are. Almost as though the shop was just down the road from you.
    I can see how easily a Mankad might be confused with a Mankini but what a terrible sight your Mum must see n her imagination each time the Mankad is mentioned.
    xxx Huge Hugs xxx.

    1. I think that as far as mother is concerned the mankini is Not Cricket….
      Goodness only knows what her reaction would be if she saw cricketers in mankinis on the box…but I would lay money that she wouldn’t put a towel over the screen as she used when Alec Douglas Home came on – ‘looks like a death’s head’ – and does when Cameron appears – ‘face like a mobile bum’…

      As we pay the CAJA (NHS) subs here all is free, but I know roughly what the treatment costs as when we moved to France’ furriners’ could not join their health system so we had to take out private health insurance and thus saw the bills – a five day cycle of treatment costs about ten thousand quid for the immunoglobulin alone.

      The problem with big teaching hospitals is that they are located either in places so expensive that a house costs a fortune or in areas where you would hesitate to venture out at night……we had a similar journey to make when living in rural France…but there we .couldn’t use an ambulance as the service could not transport across the departmental line…

      As for the shopping…the wonders of technology! This way she gets the bulk of her shopping delivered and can still take a wander round the shops if the fancy takes her without having to load up a trolley.

  3. At least Leo knows what it is and how it should be treated..with urgency it would seem. I do hope he is feeling better now. My man has also been back and forth to two different hospitals while I’m away for lots of tests. These men annoy the hell out of us but we hate them to be ill don’t we?

    1. In the early days it was misdiagnosed and treatment given which exacerbated the problem…these days at least doctors know what to do!

      I don’t know if you notice the same thing…how neat and clean the house is when men are in hospital…

  4. Sounds like a nasty affliction, I hope he stays well. Being near a hospital for me means being 20 minutes down the road. An hour and a half going down a mountain is ‘a long way’. Especially for visitors like yourself who have to do the trip twice. As you say, thank goodness for Danilo!

  5. I think more Keystone Cops than Cecil b de mille. Sounds a nightmare. They probably havent even heard of immunoglobulin in Gib! Did you spend a few nights in San José or did you go back to the finca every visit? But still, it gave us both a laugh this morning as I read it out loud. Visiting hours in Gib are technically 5.45 – 7.45, which invariably translates to somewhere around six to sometime after eight. Only three visitors per bed which really means all immediate and extended family. I was there with A who came for half an hour max, surrounded by two locals sometimes with more than a dozen visitors around their beds. I loathed visiting hours. The peace when it was over was wonderful.

    1. Visitors! As soon as people knew that Leo was in hospital they had cousins and aunts who worked in the place smuggling them in at all hours…he said that it was very frustrating as because his face was paralysed he could not articulate a request that they take themselves somewhere that the sun did not shine…particularly the woman who decided to pray for him at the bedside. Luckily the nurses gave her the heave ho before she had the whole place fingering its beads…
      He did appreciate the kind intentions…but with his head clanging like a steam hammer could not muster the strength to accept them in the sense in which they were offered…

  6. So glad that Leo is back home and hopefully fully on the mend but what a horrible experience when you know that he was in trouble. As for the cricket I could only laugh, I know from my 95 y o FIL how he gets things a little muddled at times when he does not hear the whole story and he comes up with some odd ideas. Yes we also order from time to time on the internet for him, but thankfully he has a farmer friend who meets him on Friday and they walk to Sainsburys together and shop. The farmer friend does all the carrying and the walk to town does FIL good. He is amazingly active for his age though at last we have convinced him to carry a walking stick. The latter took a long time as said it made him look like a old man!!
    Take care both of you. Diane

    1. It is horrible…the paralysis advances under your eye,as it were.
      But there has been an unexpected side effect of the treatment….it has flushed out the ‘big’ proteins caused by his cancer which were making his blood coagulate – as you can imagine we’re more than delighted to have not only treatment for the CANOMAD but also something which has improved his chances with the cancer too.
      I did like the idea of FIL refusing to use a stick!

  7. Canomad sounds horrid but despite the farcical situation you describe in the hospital, I am glad that they could help. . I can only imagine what sort of cricket match picture could be drawn by an artist who had access to the inside of your mother’s head! And I do hope Leo is feeling much better now.

  8. ‘Geçmiş olsen!’ as we say in Turkey to Leo (bad construction but you’ll understand the sentiment) – as for mother, her experience must be ‘in the flesh’ as she patently doesn’t use a computer. You should consider a ‘carer’ to keep a close eye on her obsessions!

  9. I’m so sorry to hear of this ongoing medical crisis with your husband. Thankfully, they did find something that helps. I hope you’re okay. I’m assuming that from the last photo your brilliant and ever so intelligent sense of humor remained in tact. Sending you love and kind thoughts today, for you both. And the fur/feather babies. Paulette

  10. In the early days they used cortisone which set off a full blown attack…and on his last attack in France (one of the main reasons for leaving) some young doctor out to make a name for himself altered the treatment protocol which left Leo with permanent damage. So thank goodness for San Juan de Dios staff who go by the book.

    Many thanks for your kind wishes.

  11. Oh dear, I had to look up several of your words: Canomad, of course, selah, mankad and even mankini.

    I am sorry that Leo suffers from such an unusual condition, but you seem to have it covered and have got used to dealing with it.I am glad that your hospital’s chaotic solution to the no bed available situation worked out in Leo’s favour.

    Your sense of humour and all-round efficiency notwithstanding I am sure that each recurrence must be frightening.

    I had an auto-immune disease (well, still have it, although I’m in remission) which made itself believe that it urgently needed to kill off my kidneys, so I have a faint inkling of what is involved.

    To you, dear Bead, and Leo, my very best wishes and lots of love.

    PS: I am getting to know a lot about CR. Is it becoming a must-see holiday destination?

  12. I’m glad your husband has been able to return home, and that you no longer have to pass by the hospital gestapo in order to visit him. I’ve never heard of this condition, so will be doing some Googling after I post this comment. It must be the season for hospital stays. My mom has been in the hospital for the past week, and I have traveled down to Spokane, Washington where she lives to be with her. After reading your post I will have a new appreciation for the fact I can walk in the front door of the hospital without having to be frisked for food, and proceed up to her room at any hour of the day I choose.

    1. I hope your mother picks up soon and that normal life can resume.

      They are very genial gestapo…mark you, whether I would be so sunny about it if I’d had to tail on the the visitors’ queue instead of parking myself among the pensioners I don’t know.

  13. Those auto immune diseases are unpleasant little devils,aren’t they!
    Current thinking is that Leo’s little delight was triggered by multiple vaccinations ahead of a flight to Sierra Leone all those years ago.;

    Thank you for your kind wishes…they are most appreciated as, however much one might know the symptoms and know what action to take, there is always the worry that the treatment might not start soon enough or that for some reason it might not work.

    Granny Giles did sterling work..she had people sorted into walking wounded and others; she had beds lining the corridors with drips attached to the water pipes above…porters were kept busy shoving even more beds into available wards…but it clearly was less than tactful to ask for a coffee…

    C.R..a must-see holiday destination? It is if you keep away from anything mentioned in a guidebook and enjoy traveling by bus.

  14. Glad to know Leo got prompt and appropriate treatment and is now on the mend. But the 1½ hour journey each way must be pretty exhausting on top of all the general anxiety. Hospitals these days seem to be always on the verge of chaos and only kept in some sort of order by brilliant organisers like Granny Giles. As for the mankini – I can’t imagine any woman who would find such a ludicrous garment attractive.

    1. Quite agree on the mankini…

      Granny Giles was superb….and I imagine that any hospital Emergency department is pretty chaotic at the best of times. What did strike me was that although the staff were rushed off their feet the doctor running someone’s case would make a point of checking with his or her patients regularly to keep them up to date on progress.
      Yes.the bus trip took considerably longer then the ambulance ride…I was usually asleep on the return trip!

  15. So glad to hear Leo is home again and that the treatment has had such an unexpected but welcome side-effect. Despite the apparent chaos the CR health system sounds very efficient. Your description of the ambulance ride made me chuckle and brought back memories of my own long distance trips to hospital over the past couple of years. No speed bumps but endless twists and turns on the winding roads across the Cambria Mountains and the NW Highlands.

    1. His specialist had a big smile when he told him the good news…Leo will be very weak for a while as the treatment is quite rough on the body,but the relief from the effects of the cancer is more then welcome!

      People moan about the CAJA – as they moan about the NHS upon which it was modeled – but it does a good job.

      Yes, you’ve been quite a connoisseur of upcountry ambulance trips lately… let’s hope that you have had your ration!

      1. Hi I’ve just been reading through after googling CANOMAD as my partner has been diagnosed with it and there doesn’t seem to be much information about it. How is your husband now? I hope you don’t mind me commenting. Thanks

  16. Good news that Leo has escaped the pork scratchings free zone and the unexpected bonus of the side effects of the treatment!

    I have no doubt that “Granny Giles” could have cleared beds of the possible malingerers should she announce that the mankini would be issued as standard hospital male patient wear. On the other hand the nurses would probably have quit.

    1. Perhaps the lack of pork scratchings contributed…

      Don’t tell Jeremy Hunt your idea about the mankini…not only would he adopt it he would probably have shares in the company making it…

    1. No one sleeps on this blog…if shock tactics are required, shock tactics will be used…
      Thank you: we avoided lift off on the return journey and Leo is making a slow recovery watched for every twitch of movement by four dogs determined not to let him out of their sight. And I brought Monty up for a cuddle as well as he was hooting furiously when he heard Leo’s voice again..

  17. I missed this earlier, but am glad hubby is recovering. I’d never heard of CANOMAD; I looked it up and it seems quite frightening. Nothing like being diagnosed with a “rare” condition, is there?

    1. It can work two ways….either they’ve never heard of it or, if you’re lucky, you’re a medical curiosity!
      It is distinctly horrible and takes a long recuperation even if the treatment was started rapidly.
      He is very tired, still has migraines and double vision, hands not too good either but can get about with care on good days.
      At least he can now speak and swallow solid food.

  18. Holy cow. Your vivid prose made me smile at the mental vision it conjured up though I’m sure it was quite ‘un-smiley’ while happening. Glad all’s well that ends well. Sending ‘pawsitive’ thoughts for a full recovery your way.

    1. Many thanks for the pawsitive thoughts!
      It is very nasty while it is all happening….though I had begun to wonder after the incident with the speed bumps whether the service was Costa Rica’s idea of an air ambulance…

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s